Validación de una escala de predicción de lesiones intracraneales para trauma cráneo-encefálico en niños de 0 a 5 años del Hospital Vicente Corral Moscoso Enero-Diciembre 2014. Estudio de test diagnóstico

Abstract

Objective: To determine the validity of a clinical prediction rule for intracranial lesions in children between 0 to 5 years with cranial trauma in pediatric emergency, HVCM, 2014. Methodology: A diagnostic test study was performed, the sample was calculated with the sampling constraints: sensitivity 80%, specificity: 80%, alfa: 5% expected prevalence: 10%, 7% added loss being all 409; children aged 0 to 5 years with cranial trauma and a legal representative who agreed to participate through informed consent were included, abandonment of service and inability to perform head CT were excluded. The EPLIC scale was designed by the author and subject to validation of theoretical construct. In all cases the scale was filled and CT was performed as "gold standard" for identifying intracranial lesions, which was analyzed in a blinded fashion. The information was processed in SPSS and obtained: sensitivity, specificity, PV +, PV-, LR + and LR-. Results: 41 patients had intracranial injury (10%), the most frequent lesion was cerebral edema (56%). The most sensitive clinical parameter was: fall from height (95.1%), the highest specificity: presence> 2 seizures (100%). A total score of 4 or more had the best combined sensitivity with better specificity (97.6% and 78.26%). The AUC for this score was 0.908. Conclusions: EPLIC scale is valid for predicting intracranial lesions and therefore may be a useful tool for evaluation and management of children under 5 years with TEC